{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T08:57:47Z","timestamp":1768553867493,"version":"3.49.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,3,3]],"date-time":"2020-03-03T00:00:00Z","timestamp":1583193600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Consejo Nacional de Ciencia Technologia-Mexico","award":["556490"],"award-info":[{"award-number":["556490"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Dengue is commonly considered an acute illness and follows three phases: febrile, critical in some cases and recovery. However, a number of studies have described a continuation of dengue symptoms for weeks or months, extending the recovery phase. Here we evaluate this persistence of dengue symptoms during convalescence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Our clinical cohort study included patients who sought medical services 48 to 144\u00a0h from the onset of fever at seven hospitals or ambulatory centers in Morelos, Mexico. Seventy-nine laboratory-confirmed dengue patients were followed up regularly using clinic and\/or home visits and telephone calls for as long as symptoms persisted or up to 6\u00a0mo.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 55.7% of patients had dengue-related symptoms 1 mo after the onset of fever; pain and dermatological manifestations were the most common persistent symptoms. Prognostic factors for symptom persistence were: \u22654\u00a0d of fever (RR\u00a01.72; 95% CI 1.35 to 2.19), platelet count \u2264100\u2009000\/mm3 (RR\u00a01.20; 95% CI 1.20 to 2.20), petechiae\/bruises (RR\u00a01.97; 95% CI 1.56 to 2.48) and abdominal pain\/hepatomegaly (RR\u00a01.79; 95% CI 1.41 to 2.28).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Persistence of dengue symptoms were common in laboratory-confirmed dengue patients. Manifestations related to tissue damage were associated with persistence after 30\u00a0d; host characteristics, such as age and health status before infection, were associated with prolonged persistence (&amp;gt;60\u00a0d). The burden of dengue may be higher than previously estimated.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/trstmh\/traa007","type":"journal-article","created":{"date-parts":[[2020,1,20]],"date-time":"2020-01-20T20:10:52Z","timestamp":1579551052000},"page":"355-364","source":"Crossref","is-referenced-by-count":22,"title":["Persistence of symptoms in dengue patients: a clinical cohort study"],"prefix":"10.1093","volume":"114","author":[{"given":"Diana Carolina","family":"Tiga-Loza","sequence":"first","affiliation":[{"name":"Programa de enfermer\u00eda, Universidad Manuela Beltr\u00e1n, Bucaramanga, Santander, Colombia"},{"name":"Centro de investigaciones sobre enfermedades infecciosas, Instituto Nacional de Salud P\u00fablica, Cuernavaca, Morelos, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth A","family":"Mart\u00ednez-Vega","sequence":"first","affiliation":[{"name":"Escuela de Microbiolog\u00eda, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo A","family":"Undurraga","sequence":"first","affiliation":[{"name":"Escuela de Gobierno, Pontificia Universidad Cat\u00f3lica de Chile, Santiago, Chile"},{"name":"Millennium Nucleus for the Study of the Life Course and Vulnerability (MLIV), Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia A","family":"Tschampl","sequence":"first","affiliation":[{"name":"Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald S","family":"Shepard","sequence":"first","affiliation":[{"name":"Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Ramos-Casta\u00f1eda","sequence":"first","affiliation":[{"name":"Centro de investigaciones sobre enfermedades infecciosas, Instituto Nacional de Salud P\u00fablica, Cuernavaca, Morelos, M\u00e9xico"},{"name":"Universidad Anahuac, Centro de Investigaci\u00f3n en Ciencias de la Salud. M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,3,3]]},"reference":[{"issue":"7446","key":"2020050408274168900_ref1","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1038\/nature12060","article-title":"The global distribution and burden of dengue","volume":"496","author":"Bhatt","year":"2013","journal-title":"Nature."},{"issue":"10159","key":"2020050408274168900_ref2","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.1016\/S0140-6736(18)32203-7","article-title":"Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: A systematic analysis for the global burden of disease study 2017","volume":"392","author":"Roth","year":"2018","journal-title":"Lancet."},{"issue":"8","key":"2020050408274168900_ref3","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1016\/S1473-3099(16)00146-8","article-title":"The global economic burden of dengue: A systematic analysis","volume":"16","author":"Shepard","year":"2016","journal-title":"Lancet Infect Dis."},{"issue":"10159","key":"2020050408274168900_ref4","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1016\/S0140-6736(18)32335-3","article-title":"Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: A systematic analysis for the global burden of disease study 2017","volume":"392","author":"Kyu","year":"2018","journal-title":"Lancet."},{"issue":"9","key":"2020050408274168900_ref5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0074263","article-title":"The worldwide association between television viewing and obesity in children and adolescents: Cross sectional study","volume":"8","author":"Braithwaite","year":"2013","journal-title":"PLoS One."},{"issue":"4","key":"2020050408274168900_ref6","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.trstmh.2006.08.007","article-title":"What do community-based dengue control programmes achieve? 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